Kodi puloteni iyi ya M ndi vuto la impso zanu? (Monoclonal Gammopathy of Renal Significance - MGRS) Tiyeni tikambirane za izi!

Tonsefe tikudziwa kuti impso zathu ndi chiwalo chofunikira kwambiri chomwe chimagwira ntchito yake mwakachetechete. Komabe, nthawi zina impso zimenezi zimathanso kudwala mwakachetechete. Lero tikambirana za matenda omwe amayambitsa matenda a impso, omwe angawoneke ovuta pang'ono mukamva dzinalo, koma ndi osavuta kumva. Izi zimatchedwa MGRS (Monoclonal Gammopathy of Renal Significance) . Ngakhale dzinalo ndi lalitali pang'ono, musadandaule, tiyeni timvetse mosavuta.

Kodi MGRS ndi chiyani?

Chabwino, tiyeni tiwone chomwe MGRS ndi. Mwachidule, MGRS ndi gulu la matenda omwe amawononga impso. Kuwonongeka kumeneku kumachitika chifukwa maselo ena a m'magazi a thupi lathu, kapena maselo a B (awa ndi mitundu ya maselo oyera a magazi), amapanga makope ambiri a iwo okha, kapena amapanga makope ofanana . Taganizirani izi ngati makina opanga makope angapo a pepala lomwelo.

Maselo a m'magazi omwe amapangidwa mwanjira imeneyi amapanga mtundu wa antibody wotchedwa M protein . Mapuloteni a M awa amasungidwa m'ziwalo zosiyanasiyana za thupi lathu, makamaka impso, ndikuyamba kuziwononga.

Chofunika kwambiri ndichakuti MGRS si khansa. Komabe, anthu ochepa omwe ali ndi MGRS amatha kudwala khansa, monga multiple myeloma . Chifukwa chake ndikofunikira kudziwa izi.

Kodi pali mitundu ya MGRS?

Inde, pali mitundu yoposa khumi ndi iwiri ya matenda a MGRS. Izi zimagawidwa malinga ndi gawo la impso lomwe mapuloteni a M amakhudza. Pali magulu atatu akuluakulu:

1. Matenda a glomerular

Mtundu wofala kwambiri wa MGRS ndi glomerulopathies . Izi zimawononga mitsempha yamagazi yaying'ono mkati mwa impso. Zili ngati ma meshes mu fyuluta yamadzi. Matenda ena omwe ali mgululi ndi awa:

• Amyloidosis ya impso. Izi zikuphatikizapo mitundu yotchedwa AL amyloidosis, AH amyloidosis, ndi AHL amyloidosis.
• Cryoglobulinemic glomerulonephritis (CG).
• Fibrillary glomerulopathy (FGN).
• Immunotactoid glomerulopathy (ITG).
• Matenda a glomerular okhudzana ndi mapuloteni a monoclonal. Izi zikuphatikizapo matenda otchedwa `light chain` ndi `heavy chain deposition diseases`.

2. Matenda a Tubulo-interstitial

Matendawa amakhudza machubu (machubu) omwe amanyamula zakudya ndi madzi osefedwa ndi impso kubwerera m'magazi, ndi minofu yozungulira impsozo. Zitsanzo zina ndi izi:

• Matenda a Fanconi (LCFS) a unyolo wopepuka.
• Unyolo wopepuka wa proximal tubulopathy (LCPT) wopanda makristalo.
• Histiocytosis yosungira makristalo.

3. Matenda omwe amakhudza mitsempha yamagazi mkati mwa impso (zilonda za mitsempha yamagazi ya m'kati mwa impso)

Matendawa amakhudza mitsempha yamagazi mu impso. Chitsanzo ndi atypical hemolytic uremic syndrome (aHUS) . Izi zimachitika pamene mitsempha yaying'ono yamagazi mu impso imatsekedwa ndi magazi kuundana.

Kodi MGRS ndi yofala bwanji?

Matenda a MGRS ndi matenda osowa kwambiri . Akuti amakhudza anthu ochepera 1% mwa anthu onse. Amafala kwambiri mwa anthu azaka zopitirira 60 .

Kodi zizindikiro za MGRS ndi ziti?

Zizindikiro za MGRS zimatha kusiyana malinga ndi mtundu wa MGRS womwe muli nawo. Zizindikiro zina zodziwika bwino ndi izi:

• Kumva kutopa kwambiri (kutopa) .
• Kutupa m'miyendo ya m'munsi, m'mapazi, kapena m'miyendo. Nthawi zina m'mimba, m'manja, kapena nkhope zimathanso kutupa.
• Matenda a Nephrotic syndrome amapezeka. Izi zimadziwika ndi kutuluka kwa mapuloteni mu mkodzo ndi kuchuluka kwa cholesterol m'magazi.
• Mkodzo wokhala ndi thovu kapena sopo . Ichi chikhoza kukhala chizindikiro cha mapuloteni mu mkodzo (proteinuria).
• Kukodza pafupipafupi ndikofunika kukodza pafupipafupi.
• Magazi mu mkodzo (hematuria) kapena mkodzo womwe umasintha kukhala pinki.
• Kusanza ndi kusanza.
• Matenda a POEMS . Uwu ndi matenda osowa kwambiri.
• Kusanza, kumva kuwawa, kapena kufooka kwa miyendo (izi ndi zizindikiro za matenda a mitsempha).
• Kusintha kwa mtundu wa khungu (mawanga owala kapena amdima).
• Kuvuta kupuma (kupuma movutikira).

Kodi chimayambitsa MGRS ndi chiyani?

Chifukwa chachikulu cha MGRS ndi kuwonongeka kwa impso komwe kumachitika chifukwa cha mapuloteni a M omwe atchulidwa pamwambapa. Mapuloteni a M ndi mtundu wa antibody womwe sugwira ntchito bwino, ndipo umapangidwa molakwika. Amapangidwa kuchokera ku ma clones owonongeka (makope) a maselo a plasma, mtundu wa maselo oyera amagazi, kapena maselo a B.

Anthu ena akhoza kukhala ndi maselo a plasma omwe amapanga mapuloteni a M popanda kuvulaza ziwalo zilizonse. Vutoli limatchedwa Monoclonal Gammopathy of Undetermined Significance (MGUS) . Komabe, mwa anthu omwe ali ndi MGRS, mapuloteni a M awa amaunjikana m'impso ndikuziwononga.

Kodi chifukwa chachikulu cha MGRS ndi chiyani?

Akatswiri sakudziwabe chomwe chimayambitsa MGRS. Matenda a autoimmune , kusintha kwa majini , matenda, ndi zinthu zachilengedwe zonse zikuganiziridwa kuti zimayambitsa vutoli.

Kodi ndi mavuto otani omwe angachitike chifukwa cha MGRS?

Ma clones a maselo a plasma ndi MGRS awa angayambitse kuwonongeka kwa impso, zomwe zingayambitse mavuto aakulu. Zina mwa izi ndi izi:

• Matenda a impso osatha (CKD) .
• Matenda a impso (impso) kumapeto kwa gawo .
• Kulephera kwa impso .
• Kusanduka matenda ena. Mwa anthu ena, kuchuluka kwa maselo a plasma kumawonjezeka kwambiri kotero kuti kumatha kukhala khansa ya maselo oyera otchedwa multiple myeloma (MM) . MGRS imathanso kukhala khansa zina, monga Waldenström macroglobulinemia , chronic lymphocytic leukemia (CLL) , kapena B-cell lymphoma .

Kodi matenda a MGRS amapezedwa bwanji?

Dokotala akhoza kutsimikizira MGRS mwa kuchita biopsy ya impso . Izi zimaphatikizapo kutenga chidutswa chaching'ono cha minofu kuchokera ku impso yanu ndikuyesa mapuloteni a M. Angayesenso zitsanzo za magazi anu, mkodzo, kapena mafuta a m'mafupa.

Kodi pali chithandizo cha MGRS?

Inde, pali mankhwala a MGRS. Madokotala amachichiza ndi mankhwala ofanana ndi chemotherapy ya khansa. Mankhwalawa amapha maselo ovuta kapena kuwaletsa kupanga makope ambiri. Mankhwala ena angathandize kuchepetsa kutupa. Cholinga chachikulu cha chithandizo ndikuthandizira impso zanu kugwira ntchito ndikuziletsa kuwonongeka.

Nthawi zina za MGRS, madokotala amathanso kuyika maselo oyambira m'thupi . Izi zimalowa m'malo mwa maselo anu owonongeka ndi maselo athanzi. Ngati impso zanu zawonongeka kwambiri, mungafunikenso dialysis kapena kuyika impso .

Mankhwala ndi mankhwala enaake omwe amagwiritsidwa ntchito pa MGRS

Mtundu wa mankhwala omwe mupatsidwa udzadalira mtundu wa MGRS womwe muli nawo. Nazi njira zina zochiritsira:

• Ma antibodies a monoclonal - mwachitsanzo rituximab, daratumumab.
• Mankhwala oletsa ma proteasome - mwachitsanzo bortezomib, carfilzomib, ixazomib.
• Mankhwala oletsa chitetezo chamthupi - mwachitsanzo thalidomide, lenalidomide, pomalidomide.
• Mankhwala oletsa kutupa - mwachitsanzo cyclophosphamide, bendamustine, melphalan.
• Corticosteroids - mwachitsanzo prednisone, dexamethasone.
• Kusamutsa maselo oyambira a Autologous.

Kodi zotsatirapo zake ndi ziti?

Mankhwala monga chemotherapy angayambitse zotsatirapo zoyipa zambiri, nthawi zina ngakhale kuwonongeka kwa ziwalo. Ichi ndichifukwa chake madokotala amasankha mosamala kwambiri kuti apindule kwambiri ndi mankhwalawa ndikuchepetsa chiopsezo cha zotsatirapo zoyipa. Zina mwa zotsatirapo zoyipa zomwe mungakumane nazo ndi izi:

• Anemia ( kusowa kwa magazi).
• Kutuluka magazi.
• Kudzimbidwa.
• Kutsegula m'mimba.
• Wotopa.
• Kuwonjezeka kwa chiopsezo cha matenda opatsirana ndi mavairasi, mabakiteriya ndi bowa.
• Chakudyacho sichikoma.
• Kusanza ndi kusanza.

Kodi MGRS ingapewedwe?

Popeza sitikudziwa chomwe chimayambitsa MGRS, pakadali pano palibe njira yeniyeni yopewera izi.

Kodi mungayembekezere chiyani ngati muli ndi MGRS?

Ngakhale kuti MGRS ndi matenda ochiritsika, nthawi zambiri satha kwathunthu. Amatha kubwereranso mukalandira chithandizo. Ngati impso zanu zawonongeka kwambiri, mungafunike kuikidwa impso zina.

Pafupifupi 18% ya anthu omwe ali ndi MGRS pambuyo pake adzadwala khansa yotchedwa multiple myeloma. Chifukwa chake, dokotala wanu adzakuyang'anirani nthawi zonse pogwiritsa ntchito magazi ndi mkodzo, chifukwa izi zitha kuzindikirika msanga ngati zitachitika.

Kodi mungakhale ndi moyo wautali bwanji ndi MGRS?

Kutalika kwa nthawi yomwe mungakhale ndi MGRS kumadalira mtundu wa MGRS womwe muli nawo, kuopsa kwake, komanso momwe mumayankhira chithandizo. Anthu omwe ali ndi vuto la impso lochepa amakhala ndi chiyembekezo chabwino kuposa anthu omwe ali ndi vuto lalikulu. Mwachitsanzo, mu kafukufuku wina, anthu omwe ali ndi amyloidosis yogwirizana ndi MGRS amakhala ndi moyo pafupifupi zaka 10 atapezeka ndi matendawa. Koma anthu omwe alibe amyloidosis amakhala ndi moyo wautali kwambiri. Komanso, anthu omwe amayankha bwino chithandizo amakhala ndi zotsatira zabwino kwambiri.

Kodi ndimadzisamalira bwanji?

Onetsetsani kuti mwatsatira malangizo aliwonse omwe dokotala wanu wakupatsani okhudza kusamalira thanzi la impso zanu kunyumba. Izi zingaphatikizepo kuchepetsa zinthu monga mowa, ndi kuwongolera zoopsa za matenda a impso, monga kuthamanga kwa magazi ndi matenda a shuga. Ngakhale zinthuzi sizingachiritse mwachindunji MGRS, zingathandize kuchepetsa chiopsezo cha kuwonongeka kwina kwa impso. Dokotala wanu angakuthandizeninso kuthana ndi zotsatirapo zoyipa za chithandizo.

Kodi ndiyenera kupita kwa dokotala liti?

Ngati muli ndi zizindikiro za vuto la impso, monga kutupa, mkodzo wooneka ngati thovu kapena pinki, kukodza pafupipafupi, kapena kukodza pang'ono, onetsetsani kuti mwaonana ndi dokotala.

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Zingakhale zothandiza kufunsa dokotala wanu mafunso awa:

• Ndi mankhwala ati omwe alipo a mtundu wa MGRS womwe ndili nawo?
• Kodi ndingachite chiyani kuti ndipewe kuwonongeka kwa impso?
• Ndi zizindikiro ziti zatsopano kapena zoipitsitsa zomwe ndiyenera kuyang'anitsitsa?

Pomaliza, chinthu chofunikira kwambiri (Uthenga Wopita Nawo Kunyumba)

MGRS ndi matenda oopsa omwe angawononge impso mwanjira yomwe ingakhale yoopsa. Koma kumbukirani kuti si aliyense amene ali ndi MGRS amene adzadwala khansa. Dokotala wanu adzakuyang'anirani nthawi zonse ndikuchitapo kanthu kuti adziwe ndikuchiza mavuto atsopano mwamsanga . Mankhwala atsopano tsopano akuthandizani kukonza moyo wanu ndikuchepetsa chiopsezo chanu cha matenda oopsa. Chifukwa chake musachite mantha, tsatirani upangiri wa dokotala wanu, ndipo muthane ndi vutoli.

` MGRS, Monoclonal Gammopathy of Impso Revenue Location, Matenda a Impso, Mapuloteni a M, Maselo a Plasma, Impso Biopsy, Nephrotic Syndrome, Multiple Myeloma